A review of the changes in casting since the introduction of improved synthetic casting materials in the 1970s is presented. There is very little in the literature on nursing implications regarding the newer casting materials. Improvements in synthetic materials used in the casting of children include a fiberglass-free, latex-free casting polymer, with child-friendly prints now available. Though the use of synthetic casting predominates the market, plaster of Paris is still the mainstay for serial casting and casting requiring superior moldability and conformability. The advantages and disadvantages of synthetic and plaster of Paris casting, as well as nursing care of the child in each type of cast are summarized.